News in brief - May 19, 2003

Florence Nightingale bipolar? - Prevnar hailed as a success - Stroke centers help rural physicians - HHS marks 50th anniversary - Intimate partner violence costs billions, says CDC

Florence Nightingale bipolar?

The founder of modern nursing, Florence Nightingale, may have had a bipolar disorder, according to experts presenting at the annual historic clinicopathologic conference in May sponsored by the University of Maryland School of Medicine and the Veterans Affairs Maryland Health Care System in Baltimore. The annual event attempts to diagnose the ills of various historical figures.

Historians have long blamed Nightingale's fevers, fatigue, spinal pain, nervousness and depression on chronic brucellosis.

Experts at this conference, however, said that while Nightingale may had the common bacterial infection, it was not sufficient to explain her severe mood swings and her times of great productivity.

"It is my opinion that Florence Nightingale suffered from bipolar disorder," said Kathy Wisner, MD, professor of psychiatry and ob-gyn at the University of Pittsburgh Medical Center. "Florence heard voices and experienced a number of severe depressive episodes in her teens and early 20s -- symptoms consistent with the onset of bipolar disorder."

Prevnar hailed as a success

The pneumococcal polysaccharide vaccine, or Prevnar, introduced in 2000 to prevent invasive infection by pneumococcal bacteria, has been a major public health success story, according to new research. Since its introduction, the vaccine has resulted in about 20,000 fewer cases of meningitis, ear infections, pneumonia and other maladies. The declines were especially great among the youngest children.

A study in the May 1 issue of the New England Journal of Medicine shows that the rate of infection among children younger than 2 in seven cities across the nation dropped by 68% from 1998 to 2001.

The rate of infection in unimmunized adults dropped as well, said the study, probably because the vaccine eliminated or reduced the number of germs in children who normally serve as reservoirs of pneumococci.

"Of course the vaccine looked very good in the laboratory and in efficacy field trials, but this is very, very good news under real-world conditions," said Richard Insel, MD, a University of Rochester scientist who had a hand in creating the vaccine more than two decades ago.

Physicians at the university are currently conducting a study to see if Prevnar is also effective in preventing pneumonia in elderly patients.

Stroke centers help rural physicians

A regional system that gives rural physicians 24-hour access to a neurologist greatly improves stroke patients' chances of getting clot-busting therapy, researchers reported in the May 1 rapid access edition of Stroke: A Journal of the American Heart Association.

The regional system studied is the Mid America Brain and Stroke Institute at Saint Luke's Hospital in Kansas City, Mo. It is staffed by a team of six neurologists, who help outlying physicians evaluate patients, decide on treatment and transfer patients to Kansas City when necessary, and two neurointerventional radiologists.

The system includes a central phone number, nicknamed Doc One, that physicians within a 100-mile radius of Saint Luke's can call. A nurse, who gets patient information and relays it to the neurologist on call, staffs Doc One around the clock.

Giving intravenous tissue plasminogen activator dissolves the blood clots that cause ischemic stroke and helps reduce permanent disability. It is the only approved treatment for acute ischemic stroke, but it must be delivered within three hours of symptom onset to be effective.

HHS marks 50th anniversary

The Dept. of Health and Human Services celebrated its 50th birthday in April, and Secretary Tommy Thompson reiterated the agency's determination to keep up its hard work.

"For 50 years, the dedicated professionals in our department have helped Americans lead healthy and productive lives," said Thompson. "But we also know the potential for further improvement in our nation's health, welfare and security. That's why we must, and will, continue to lead in the medical sciences, in public health and in strengthening and improving America's health and safety net programs."

The agency was formed in April 1953 as the Dept. of Health, Education and Welfare and gained cabinet-level status for the government's health and social agencies. HEW became HHS in May 1980, and, despite the eventual development of Social Security and Education branches into independent agencies, it remains the largest cabinet-level department. The agency has an annual budget of $502 billion and employs 65,500 people.

Intimate partner violence costs billions, says CDC

Violence from significant others costs $4.1 billion per year in direct health care-related costs. Productivity losses cost the country another $1.8 billion, according to the report, "Costs of Intimate Partner Violence Against Women in the United States," published by the Centers for Disease Control and Prevention last month.

The CDC is developing a guide to interventions for batterers, as well as plans to fund rape prevention programs, finance domestic violence coalitions and provide money for data collection systems. "For the health of our country, it is critical that we stop this cycle now," said Health and Human Services Secretary Tommy Thompson.